Health ministry concedes resource shortage, surprised doctors withdraw from task force
The Permanent Secretary in the Health Ministry, Dr Kevin Harvey, has responded to charges by the Jamaica Medical Doctors' Association about the lack of resources and unsanitary conditions in health facilities including operating theatres.
"There is a need for additional supplies, better management structures and more efficient use of existing resources," Harvey said in a release this afternoon.
He also said he was surprised at the decision of the doctors to withdraw from the task force established to examine the possibility of revised working hours.
SEE FULL TEXT OF HARVEY'S RESPONSE BELOW:
Ministry of Health is surprised at the withdrawal of the Jamaica Medical Doctors Association from the task force that was established to develop recommendations as to the feasibility of, approach and design of revised working hours for physicians in the public health sector. The Ministry is willing, ready and hoping to continue discussion with the JMDA on how to deliver better health care to the Jamaican people.
The task force is chaired by Dr. Carl Bruce, Consultant Neurosurgeon at the University Hospital of the West Indies and includes the Dean of the Faculty of Medical Sciences, Professor Horace Fletcher, Medical Chief of Staff of the UHWI, Professor Trevor McCartney, the Association of Government Medical Consultants, the Medical Association of Jamaica and the Jamaica Medical Doctors Association. The JMDA has now indicated their intent to withdraw from the Taskforce which also involves representatives from the Ministry of Health including the Chief Medical Officer, Director of Health Services Planning and Integration and is supported by Administrative staff from the Ministry of Health, a Business Analyst and Health Economists.
Traditionally and in the main the majority of services at our hospitals are operated on a 24 hour basis. Most doctors are employed from 8:00a.m. to 4:00p.m. on a 40 hour work week basis and the remaining 128 hours of the week are staffed through rostered duty and overtime which constitute two thirds of the wage bill for physicians.
Despite this many services end at 4pm and there is a significant waiting time for clinic appointments and surgeries at some facilities which has adversely impacted the quality of care being received by the Jamaican population.
I do recognise that the working arrangement of physicians is not the only contributor to this. There is a need for additional supplies, better management structures and more efficient use of existing resources. We are addressing all of these issues through the significant increase in the 2014/2015 budget which has resulted in a doubling of the pharmaceutical budget and an increase in the budget for the maintenance of equipment and facilities from $80 million to over $500 million per year.
We are moving to restructure primary health care services to improve the quality and quantum of care and hence reduce the burden on hospitals. There has also been a marked increase in the number of Jamaican physicians graduating from local and international universities with over 250 doctors expected to complete medical school in July 2015 compared to just above 100 in the previous years.
As a physician who has worked in other jurisdictions such as the United States, Britain, Africa and of course Jamaica with experience at every level of the health system including Primary and secondary care in rural and urban communities and administration I do understand all sides of the equation.
However, it is no secret that excessive long hours of work by physicians threaten patient safety and physician well-being and in many countries a cap is now being placed on the number of hours that doctors are allowed to work in any one day.
In light of all of this the Taskforce is mandated to review international standards and best practices, current demands on the services, patterns of diseases to determine what is the best and most efficient method of absorbing the number of doctors and improving services.
At the last meeting held this week it was agreed that the Sub-committee including the Associations would look at the various models of working as exist in different countries including Jamaica and determine which would be best fit for efficiency. The Sub-committee was also to look at the financial impact any system would have on the doctors; the Associations were requested to come to the table with their bottom line in terms of income given that the Committee recognised there may be some impact.
We hope to engage all stakeholders in constructive discussion on a way forward. I hope the JMDA will reconsider their position as they are an important stakeholder in this process.